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Systematic Reviews
Published in: Systematic Reviews 1/2018

Open Access 01-12-2018 | Research

Survival estimates stratified by the Nottingham Prognostic Index for early breast cancer: a systematic review and meta-analysis of observational studies

Authors: Ewan Gray, Anna Donten, Katherine Payne, Peter S. Hall

Published in: Systematic Reviews | Issue 1/2018

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Abstract

Background

Estimates of survival for women diagnosed with early staged breast cancer are available based on stratification into prognostic categories defined using the Nottingham Prognostic Index (NPI). This review aimed to identify and summarize the estimated survival statistics from separate sources in the literature and to explore the extent of between-study heterogeneity in survival estimates.

Methods

Observational studies in women diagnosed with early and locally advanced breast cancer reporting overall survival by NPI category were identified using a systematic literature search. An exploratory meta-analysis was conducted to describe survival estimates and assess between-study heterogeneity.

Results

Twenty-eight studies were identified. Nineteen studies with sufficient data on overall survival were included in meta-analysis. A high level of heterogeneity in survival estimates was evident with I2 values in the range of 90 to 98%.

Conclusions

The substantial differences between studies in the relationship between NPI categories and survival at 5 and 10 years poses challenges for use of this prognostic score in both clinical settings and in decision-analytic model-based economic evaluations.
Appendix
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Footnotes
1
A study that takes a group (cohort) of patients and follows their progress over time in order to measure outcomes such as disease or mortality rates and make comparisons according to the treatments or interventions that patients received [47].
 
2
Cancer reappearing after a remission [48].
 
3
A proliferation of malignant-appearing cells of the ducts and terminal lobular units of the breast that have not breached the ductal basement membrane [49].
 
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Metadata
Title
Survival estimates stratified by the Nottingham Prognostic Index for early breast cancer: a systematic review and meta-analysis of observational studies
Authors
Ewan Gray
Anna Donten
Katherine Payne
Peter S. Hall
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2018
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-018-0803-9

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